Thread by @PWDAustralia

Day 4 of the #DisabilityRC hearings has now begun.

We'll be live tweeting throughout the day using the hashtags
#Covid19 #DisabilityRC.

You can also watch here:
disability.royalcommission.gov.au

The first witness is Simon Cotterell, the First Assistant Secretary for the Primary Care Division of the Department of Health.

#Covid19 #DisabilityRC

Eastman asks how many people with disability have contracted COVID-19 since January.

Cotterell responds says there is no clear data so we do not know. There is some data from the NDIS Q&S Commission.

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When asked how many people with disability have died from COVID-19, Cotterell responds that we don't know.

The only data available is that from the Quality and Safeguards Commission, which only covers people on the NDIS.

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Data is now being collected in residential care, but is still not perfect. Some states collect more data than others, but there is no national data collection.

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As of the 5th of Feb, there were no emergency response plans targeted for people with cognitive disability.

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Cotterell was not consulted in the formulation of the national response plan.

There is no reference to people with disability in the national emergency response plan for COVID-19.

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The nature of the initial plan was to communicate to the health sector about the arrangement between Commonwealth and State governments on handling the pandemic.

Cotterell says the plan was done quickly, and people worked really hard and under pressure.

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Eastman points to a section of the plan which highlights the needs of at-risk groups.

Cotterell says at-risk can mean people more vulnerable to severe illness, or at higher risk of contracting the virus.

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Eastman continues to push questions about the omission of people with disability from the plan.

It's noted that "residential settings" are included, Cotterell says this is likely meant to include people with disability.

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Counsel asks Cotterell when he first became concerned about the omission of people with disabiltiy, he says he was very busy with the primary care response and getting on with action.

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Prior to February 18th, Cotterell was resposible for implementing the National Roadmap for people with cognitive disability.

Sackville clarifies that Cotterell was a senior person within the health department responsible for people with disability.

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Sackville asks when Cotterell became aware that the emergency health response was being prepared.

Cotterell responds saying that it was getting prepared in Januray.

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Sackville asks why no one in the department who was responsible for the health of people with disability was involved with the formulating the plan.

Cotterell says they were all very busy.

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There was no consultation with the NDIS Quality and Safeguards Commission when formulating the guidelines released in March.

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Counsel asks what steps the Gov. took to to communicate with residential care facilities for people with disability after the release of the guidelines

Cotterell says that the Social Services dept. is responsible for communication with these facilities.

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Cotterell says that some of the work they've been doing with people with disability is to ensure health services are available to PWD.

Cotterell says he doesn't think the health sector was underprepared to deal with urgent care needs.

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An infection prevention and control training was released, Eastman asks what in the training had a focus for people with disability.

Cotterell says this training was aimed at care workers, and for protecting yourself. It was focused on all sectors.

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Eastman references @Kavanagh_AM report on the disability workforce, saying a significant amount of disability support workers had not received COVID-19 training. '
She asks what this says about whether the program released is having sufficient reach

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@Kavanagh_AM Cotterell says there needs to be more work done. He says the Department of Social Services is primarily responsible, but they're ready to help.

He also says they need to consider the risks of brining people together for training.

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@Kavanagh_AM Cotterell says the Department of Health needs to be in better communication with disability organisations.

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@Kavanagh_AM Eastman references the open letter published by various disability advocacy groups, including us (pwd.org.au/media-release-…)

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@Kavanagh_AM Cotterell speaks to the urgent actions put forward by the letter, noting that many of them are not under the responsibility of the Department of Health.

He says when issues are raised that don't neatly fit into a dept. they find the most appropriate dept.

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@Kavanagh_AM Cotterell asked about a guide for home care providers that don't include people with disability (again). He says he is not in a position to answer.

Eastman asks if he checked the document, he says he had not.

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Talking about the Advisory Committee, which he chaired. PWDA along with other disability advocacy organisations were members of this committee.

Government agencies were also a part of this committee.

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There is now discussion on whether the Advisory Committee and what was dicussed is protected under Cabinet in Confidence.

We're lost in this discussion but Sackville seems to be handling it.

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Eastman has jumped in saying that she's concerned that these confidentiality issues are being raised so last minute.

Sackville remains unimpressed by this issue of confidentiality.

Commonwealth says if they need the evidence, it may mean a closed session

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Everything is clarified now, Eastman is now allowed to continue questioning.

Eastman asks about the first meeting and its purpose. The purpose was to begin formulating the plan for the health of people with disability.

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We are now talking about the new plan developed for PWD. It's established the plan was developed quickly, and with input from the committee.

Eastman is clarifying that this plan was needed because the plan for the broader community was not tailored for PWD.

The Communicable Diseases Network of Australia has not collected data specific to people with disability. Discussions have been happening on how to improve this going forward.

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Eastman asks why this data collection is still a work in progress given the immediate need.

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Cotterall says we do not have specific data on PWD who have been infected with COVID19.

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Sackville asks how the Commonwealth can meet their responsibilities under the CRPD if there is not a body responsible for collecting disability specific data in relation to the pandemic. Cotterall is unable to answer at this time.

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Eastman is asking about the implementation of the plan. The most recent version of the plan was made in June. We've seen a worsening of the situation in Vic since then. Has there been any move toward revising the plan with this in mind?

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Cotterall says this has come up at the last two Advisory Committee meetings and the plan is in the process of being updated.

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Eastman asks about the planning for the roadmap for looking after people with intellectual disability. Cotterall says the work has continued. The Primary Care Enhancement Program is currently being rolled out.

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Ms Bennet asks about Cotterall's relationship with the NDIA throughout this. Cotterall says routine consultation and collaboration is now happening, though this was not the case from the beginning.

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Ms Bennet is concerned about the lack of communication between the Dept. of Health and the NDIS. Was this an impediment to the Department of Health's response? Cotterall says better collaboration early on would have improved the response. It is now a priority.

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Ms Bennet is asking about collection of data in relation to the age care sector. We have had this data for a long time. Cotterall says collection of data from other congregate living situations in now happening due to intervention from the Advisory Committee.

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Galbally is asking about intention to expand the Advisory Committee to include more DROs. Cotterall says the group was initially kept small to keep it agile, but they are looking at how to improve the set up to make it more inclusive.

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The Commission thanks Mr Cotterall for appearing today.

We are now welcoming Dr Nick Coatsworth, Deputy Chief Medical Officer, Australian Government Department of Health.

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Eastman is asking: Do we know how people with disability have had, or have died from, COVID 19 since January. Coatsworth says we do not.

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Coatsworth says inclusion of PWD in the stats was not considered vital to the control of the disease.

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Eastman asks if the vulnerability of PWD to COVID should have impacted the collection of data. Coatsworth says there are 4.4 million pwd in Australia and not all of them would be considered especially vulnerable to COVID19.

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Eastman asks if effort has been made to identify which PWD might be more at risk, and why the age care and disability sectors have been approached differently in terms of data collection.

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Coatsworth is very focussed on PWD being a very diverse group who are not uniformly impacted by COVID-19.

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Eastman wants to understand at what Coatsworth's role is in influencing the Health Dept. policy. Coatsworth usually provides relevant clinical expertise, though there have been broader roles during the pandemic, engagement with stakeholder groups and media. #Covid19 #DisabilityRC

These stakeholder groups did not include PWD. #Covid19 #DisabilityRC

Coatsworth says there is an acceptance that disability is not specifically mentioned in the broad plan. It seems to be considered acceptable that PWD are part of the broader community, therefore a plan that covers that community will cover PWD by default.

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Eastman asks if residential care guidelines were intended to cover residential care for PWD. Coatsworth said the guidelines went through a variety of scenarios and were intended to provide technical guidance so facilities could develop their own guidelines. #Covid19 #DisabilityRC

Eastman: Was the NDIS Quality and Safeguards Commission consulted in the guidelines?

Coatsworth says no. The primary reason seems to be the need for a rapid response. He says these are living documents.

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Consultation was focused on the aged care sector as this was recognised as a high risk area. #Covid19 #DisabilityRC

Eastman is asking what arrangements were made to ensure access to PPE in the disability sector outside disability accomodation. #Covid19 #DisabilityRC

Eastman asks: Unless there was a clinical need then there wasn't going to be distribution of PPE outside a health setting?

Coatsworth says NDIS participants were given access to the national health stockpile.

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What about PWD who don't have access to the NDIS?!

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Coatsworth says that early on there was a focus on only using PPE when there was evidence of a respiratory tract infection, due to awareness of global shortages of PPE.

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Eastman has raised the issue of PWD without access to the NDIS.

Coatsworth says the most relevant policy change there has been mandatory mask wearing in Victoria and NSW hotspots. #Covid19 #DisabilityRC

We're now discussing access to testing. Eastman is concerned that wheelchair access is the only form of access that has been formally addressed. #Covid19 #DisabilityRC

Eastman: What arrangements are currently in place for house or bedridden people who are unable to isolate due to dependence on support workers? Does Coatsworth accept that testing arrangement for the general population are not accessible to everyone with a disability?

Coatsworth is focussed on access to testing via primary healthcare providers. No real acknowledgement of access issues experienced by homebound and bedridden people. #Covid19 #DisabilityRC

Bennet asks about WHO statements and how they are taken into account.

Coatsworth says statements are reviewed from time to time.

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Bennet asks about the WHO statement in regard to disability. How quickly was it translated into practice in Australia.

Coatsworth refers to the NDIS participants access to PPE in March. #COVID19 #DisabilityRC

Coatsworth is talking again about broad testing measures as though all PWD could access them from the beginning. #COVID19 #DisabilityRC

Galbally is struck by the apparent view that PWD are not a priority group in health decisions, drawing attention to the DRC hearing on disability and health and issues of discrimination. #COVID19 #DisabilityRC

We are now adjourned for lunch. We'll be back live tweeting at 2pm. #COVID19 #DisabilityRC

We're now back from the break.

We're hearing from Natalia Wade from @EQLawyers first.

#COVID19 #DisabilityRC

@EQLawyers Wade speaks about the NDIS practice standards, saying they're an important part of the legislate framwork and important for the NDIS Q&S commission to respond to matters.

She says that if these standards don't prepare for emergency, it limits legal action.
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@EQLawyers Com. Bennett asks how wide spread the heavy restrictions put in place in group homes were and whether the guidelines should be separate to those of aged care.

Wade says it was common, and yes they should be separate.

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@EQLawyers That concludes the evidence for Natalie Wade.

The next witnesses are Graeme Head and Samantha Taylor.

Head is the Commissioner for the NDIS Quality and Safeguards Commission.

Taylor is the Registrar for the Commission.

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@EQLawyers According to Taylor's statement, 76 people on the NDIS who have contracted COVID-19. Over 120 disability support workers in the NDIS have contracted the virus.

There's been 8 deaths of people on the NDIS with COVID-19.

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@EQLawyers Eastman asks about the data and how this was collected.

Taylor responds that it comes from the service providers when they receive a confirmed case.

This data doesn't go to the Commonwealth Government, but to the NDIA.

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@EQLawyers Taylor says they ask providers about the location and nature of the setting where the infection happened.

The majority of the infections have been found in Victoria.

The majority of cases have been recent, and the increase has been quite significant.
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@EQLawyers Eastman asks who is primarily responsible for a person on the NDIS if they contract the virus.

Taylor responds saying it is the service provider. There are "strong connections" where outreach is provided to service providers.

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@EQLawyers Taylor says that to maintain the provision of supports, there may never be a need for anyone to intervene depending on the situation and infection.

The responsibilty of the disability support is on the service providers.

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@EQLawyers Eastman clarifies who is responsible for the health supports when someone on the NDIS contracts the virus.

Taylor says that if it is necessary, the "health system" is responsible.

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@EQLawyers Taylor says the first priority is the avoidance of infection.

She says the guidance to providers comes from the health system, and the commission follows their directive.

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Sackville notes this is a really unprecedented time for service providers, and whether "guidance" is enough to adequately support them.

Taylor says "the guidance is very strong". The health system provides strong directives to deal with outbreaks.

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Sackville asks who the service providers owe their obligations to.

Taylor says they owe their obligations to the NDIS Safeguards Comm. and to the public health orders.

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Sackville asks what the Commission does to ensure compliance to obligations.

Taylor gives a vague answer, saying that the same measures are put in place as always. There's a complaints line, and providers are required to report certain instances.

Sackville asks for clarification, that the Commission relies on advocates and people with disability reporting for themselves.

Taylor says yes, those are some of the ways they ensure providers are held accountable.

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Sackville confirms that procedures and practices have not materially changed since before the pandemic.

Taylor says yes, they have not changed.

Sackville notes we are living in a fundamentally different world.

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Taylor has established her most experienced tea to deal with complaints.

She confirms they did put in place a number of measures to understand what was happening "in the market"

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Taylor says that it is not the case that there has been a universal need for change across services because of COVID-19.

Some services have continued to operate as they would normally.

She says they have a very representative view of what is happening.
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Mr Head points out that for many providers , the regulation from the Safeguards Commission is still very new.

He says they were very concerned about adding extra complexity to the system for providers.

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Mellifont asks about the 76 infections, saying that this itself says that something isn't working.

Taylor says that this does not mean that every one of these infections is a result of failure of the service providers.
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Sackville asks about investigations into service providers or virus contractions.

There are 3 investigations going on currently, all in Victoria.

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Head says the Commission did not engage public health specialists when preparing for the pandemic. They did not intend to set up a separate line of public health advice.

He says there is "general expertise within the organisation"

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He says they have always been clear with providers that they must follow public health orders from state and federal governments.

They don't author their own public health advice, but they "point people to health advice"

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Head says that his view at the time was that Dep. of Health would be leading the health response, and that they would reflect their advice in their own materials.

He says their resources provide links to infomation produced by Commonwealth.

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Eastman asks about the health guidelines published by Health (which omitted PWD)

Both witnesses say they were not aware that the health guidelines were being published.

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Taylor says there was several discussion between officials about elevating the response for people with disability, stating that there was a lot of concern about the exclusion of people with disability in the plans.

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Eastman asks Taylor about the evidence Cottrall gave earlier, including statements given at stakeholder meetings by the Safeguards Commission.

Taylor confirms the 27 of March was the first time they were involved in stakeholder meetings focusing on PWD.

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Eastman asks about the health guidelines.

Taylor says that the reason they didn't require the guidelines to be implemented was to allow service providers to modify as needed and as it was applicable.

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Eastman asks about the importance of people with disability and service providers the need for guidelines to be centralized, she says the lack of clear information places unnecessary burden on PWD and their support workers.

Taylor disagrees.
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Taylor goes on saying the guidelines were beneficial, and appreciated by people on the NDIS.

Eastman asks to confirm that these guidelines were reliable, accurate, and clear.

There's an objection from one of the lawyers to Eastman's questioning.

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Com. Bennett confirms with Head that he raised the issues of PWD in residential and at-home settings.

He says it was Taylor that attended.

Bennett continues the question, asking if there was additional resources from the Comm. to respond to the pandemic.
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Head responds saying there were budget enhancements to respond to COVID-19. This is to assist in the respond to the pandemic.

Head says they have roughly $6.2mil to go until June 30, 2021 specific to COVID-19

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Sackville asks whether they have information about the 8 deaths and whether they were avoidable.

Taylor says "there was no concern"

#COVID19 #DisabilityRC

Head says that with new measures, deaths reported to them from the 1st of July capture more information which allow them to track things further down the track.

These new measures are not national.

#COVID19 #DisabilityRC

We're adjouning for a few minutes.

We really need a snack and some tea after that session, we highly recommend that everyone following along also take a quick break.

#COVID19 #DisabilityRC

We're back now.

A few of the witnesses haven't been able to join us, including a person with disability speaking about their experience, and Martin Hoffman, CEO of the NDIA.

Their statements are being tendered.

#COVID19 #DisabilityRC

Dr. Kirsten Harley has provided pre-recorded evidence.

She will read her statement of lived experience.

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Harley begins speaking about her experience. She lives with her family in a home they own. They haven't been impacted financially and have good internetd and broadband connection, which is important for her.

#COVID19 #DisabilityRC

Changes to her services have varied.
She sas effectively, her household contains 13 people including carers that come and go (many through public transport)

10 have contact with other households.

3 have had to take unpaid leave to get tested,
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She says work conditions mean people dont take time off to get tested because of over-casualisation of the workforce and attitudes.

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Harley talks about the care she's received from her GP and other specialists.

She talks about her anxiety about having to go to the hospital, lack of resources in possible COVID-19 treatments.

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Dr Harley talks about her mental health. She said the pandemic has been terrifying.

What would happen if a loved one got sick? if a carer got sick? if she got sick and had to compete for ICU care?

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She talks about how sociology has helped her in accepting her diagnosis of MND. It also brought discussion to social inequalities during COVID-19.

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She talks about trying to source PPE. She talks about shortages and delays to some resources, as well as the inaffordability of some items.

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She said it would not have been practical or safe for her to get essential supplies during the priority early morning shopping hours, and was grateful for priority home delivery.

#COVID19 #DisabilityRC

Not addressing the messaging, saying that a lot of the messaging was made with only able bodied people in mind.

A lot of the things, like physical distancing, were not possible for people with disability.

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That concludes the evidence for Dr. Harley and the hearing.

Mellifont now going through some of the tenders before giving closing remarks.

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Mellifont closes saying that subject to any changes, the DRC will hold several hearings before the end of the year.

This includes hearings on psychotropic medications, education, and criminal justice.

#COVID19 #DisabilityRC

All hearings for the rest of the year will be conducted in COVID safe ways, and will likely be virtual.

Mellifont notes that a lot of the content discussed in this and other hearings can be difficult, and to seek support if needed.

#COVID19 #DisabilityRC

Information is available on their website:
disability.royalcommission.gov.au/counselling-an…

we also have information on our website:
pwd.org.au/drc-hub/suppor…

#COVID19 #DisabilityRC

Sackville is now making some closing remarks.

He says this week we have heard from a variety of people with disability about their experiences thorughout the pandemic.

The commissioners wish to thank them for giving evidence.

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He says the evidence has shed a piercing light on the effects of COVID-19 on people with disability.

#COVID19 #DisabilityRC

The pandemic has taken another toll, that is hidden.

He says people with disability have lost services, medication, access to essential supplies, and have experience high levels of social isolation.
#COVID19 #DisabilityRC

He speaks about a key theme of the hearing, an anxiety of deprioritization of people with disability.

He notes the various bits of evidence from several witnesses, about people with disability feeling forgotten, put on the back seat.

#COVID19 #DisabilityRC

He says the lives, health, safety, and well being of people with disability are equal to that of anyone else.

These principles should drive attitudes and responses.

#COVID19 #DisabilityRC

Sackville proposes the following:
Counsel assisting to write a submission including the following:
-The need for data collection
-consultation between the commonwealth and disability advocacy groups
-whether the responses of the NDIA and NDIS Commission have been adequate.

- the need for paid pandemic leave
- emergency advocacy funding
- additional measures to implement a human rights based approach
-need to include PWDA and representative orgs in every level of planning for pandemic and recovery.

#COVID19 #DisabilityRC

These are just a few of the points Sackville has highligted, there was a total of about 20.

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Sackville has concluded his closing remarks, and that officially closes the 5th public hearing for this Royal Commission,

This hearing has shown the commission the issues we already knew, that PWD have been among the most impacted by this pandemic,

#COVID19 #DisabilityRC

Thank you to everyone that followed along with our live-tweeting this week!

We've heard a lot of evidence this week, much of it distressing and frustrating.

Please take care of yourselves & one another, and seek support if needed:
pwd.org.au/drc-hub/suppor…

#COVID19 #DisabilityRC